A Nipah virus infection is a
viral infection
A viral disease (or viral infection) occurs when an organism's body is invaded by pathogenic viruses, and infectious virus particles (virions) attach to and enter susceptible cells.
Structural Characteristics
Basic structural characteristics, s ...
caused by the
Nipah virus
Nipah virus, scientific name ''Nipah henipavirus'', is a bat-borne virus that causes Nipah virus infection in humans and other animals, a disease with a high mortality rate. Numerous disease outbreaks caused by Nipah virus have occurred in Sout ...
.
Symptoms from infection vary from none to
fever
Fever, also referred to as pyrexia, is defined as having a body temperature, temperature above the human body temperature, normal range due to an increase in the body's temperature Human body temperature#Fever, set point. There is not a single ...
, cough, headache,
shortness of breath
Shortness of breath (SOB), also medically known as dyspnea (in AmE) or dyspnoea (in BrE), is an uncomfortable feeling of not being able to breathe well enough. The American Thoracic Society defines it as "a subjective experience of breathing disc ...
, and confusion.
[ This may worsen into a ]coma
A coma is a deep state of prolonged unconsciousness in which a person cannot be awakened, fails to respond normally to painful stimuli, light, or sound, lacks a normal wake-sleep cycle and does not initiate voluntary actions. Coma patients exhi ...
over a day or two,[ and 50 to 75% of those infected die. Complications can include inflammation of the brain and ]seizures
An epileptic seizure, informally known as a seizure, is a period of symptoms due to abnormally excessive or neural oscillation, synchronous neuronal activity in the brain. Outward effects vary from uncontrolled shaking movements involving much o ...
following recovery.[
The Nipah virus (NiV) is a type of ]RNA virus
An RNA virus is a virusother than a retrovirusthat has ribonucleic acid (RNA) as its genetic material. The nucleic acid is usually single-stranded RNA ( ssRNA) but it may be double-stranded (dsRNA). Notable human diseases caused by RNA viruses ...
in the genus ''Henipavirus
''Henipavirus'' is a genus of negative-strand RNA viruses in the family ''Paramyxoviridae'', order ''Mononegavirales'' containing six established species, and numerous others still under study. Henipaviruses are naturally harboured by several sp ...
''.[ The virus normally circulates among some ]fruit bats
In botany, a fruit is the seed-bearing structure in flowering plants that is formed from the ovary after flowering.
Fruits are the means by which flowering plants (also known as angiosperms) disseminate their seeds. Edible fruits in partic ...
.[ It can both spread between people and from other animals to people.][ Spread typically requires direct contact with an infected source.] Diagnosis is based on symptoms and confirmed by laboratory testing.
Management is restricted to supportive care
Symptomatic treatment, supportive care, supportive therapy, or palliative treatment is any medical therapy of a disease that only affects its symptoms, not the underlying cause. It is usually aimed at reducing the signs and symptoms for the comfor ...
;[ there is neither ]vaccine
A vaccine is a biological Dosage form, preparation that provides active acquired immunity to a particular infectious disease, infectious or cancer, malignant disease. The safety and effectiveness of vaccines has been widely studied and verifie ...
nor specific treatment.[ Preventive measures include avoiding exposure to bats and sick pigs, and not drinking raw ]date palm sap
''Phoenix dactylifera'', commonly known as date or date palm, is a flowering plant species in the palm family, Arecaceae, cultivated for its edible sweet fruit called dates. The species is widely cultivated across northern Africa, the Middle Eas ...
. As of May 2018 about 700 human cases of Nipah virus were estimated to have occurred, and 50 to 75 percent of those infected died. In May 2018, an outbreak
In epidemiology, an outbreak is a sudden increase in occurrences of a disease when cases are in excess of normal expectancy for the location or season. It may affect a small and localized group or impact upon thousands of people across an entire ...
of the disease caused 17 deaths in the Indian state of Kerala
Kerala ( ; ) is a state on the Malabar Coast of India. It was formed on 1 November 1956, following the passage of the States Reorganisation Act, by combining Malayalam-speaking regions of the erstwhile regions of Cochin, Malabar, South ...
.
The disease was first identified in 1998 by a team of researchers at the Faculty of Medicine, University of Malaya
The Faculty of Medicine, University of Malaya (commonly known as the UM Medical School, FoM UM, UM Medicine or Malaya Medicine) is one of the thirteen faculties of the University of Malaya (UM). It was officially established in September 1962 a ...
during an outbreak in Malaysia
Malaysia ( ; ) is a country in Southeast Asia. The federation, federal constitutional monarchy consists of States and federal territories of Malaysia, thirteen states and three federal territories, separated by the South China Sea into two r ...
. The majority of the patients in Malaysia diagnosed with the disease were referred to and treated at the University of Malaya Medical Centre. The virus was isolated and identified in 1999. The disease is named after a village in Malaysia, Sungai Nipah.[ Pigs may also be infected, and millions were killed by Malaysian authorities in 1999 to stop the spread of disease, a measure which proved to be successful.][
]
Signs and symptoms
The symptoms start to appear five to 14 days after exposure. Initial symptoms are fever, headache, and drowsiness, followed by disorientation and mental confusion. Respiratory issues can also be present during the early stages. Coma symptoms can manifest within 24 to 48 hours. Encephalitis
Encephalitis is inflammation of the brain. The severity can be variable with symptoms including reduction or alteration in consciousness, headache, fever, confusion, a stiff neck, and vomiting. Complications may include seizures, hallucinations, ...
, inflammation of the brain, is a potentially fatal complication of Nipah virus infection. Nipah patients who have breathing difficulty are more likely than those without respiratory illness to transmit the virus, as are those who are more than 45 years of age. The disease is suspected in symptomatic individuals in the context of an epidemic outbreak.
Transmission
The initial case in human outbreaks of Nipah virus has always been zoonotic
A zoonosis (; plural zoonoses) or zoonotic disease is an infectious disease of humans caused by a pathogen (an infectious agent, such as a bacterium, virus, parasite or prion) that has jumped from a non-human (usually a vertebrate) to a human. ...
from exposure to contaminated secretions or tissues of infected bat
Bats are mammals of the order Chiroptera.''cheir'', "hand" and πτερόν''pteron'', "wing". With their forelimbs adapted as wings, they are the only mammals capable of true and sustained flight. Bats are more agile in flight than most ...
s or pig
The pig (''Sus domesticus''), often called swine, hog, or domestic pig when distinguishing from other members of the genus '' Sus'', is an omnivorous, domesticated, even-toed, hoofed mammal. It is variously considered a subspecies of ''Sus ...
s. Subsequent human-to-human transmission of Nipah virus occurs via close contact with NiV-infected persons or exposure to NiV-infected body fluids (e.g., blood, urine, nasal secretions).
Most experts do not classify Nipah virus as airborne, though there is consensus that transmission can—and does—occur from short-range exposure to NiV-infected respiratory droplets in close contact settings.
Indirect transmission of Nipah virus via contaminated fomites is likely responsible for many cases in which there was no known direct contact with a NiV-infected
person or animal.
Risks
The risk of exposure is high for hospital workers and caretakers of those infected with the virus. In Malaysia and Singapore, Nipah virus infected people with close contact to infected pigs. In Bangladesh and India, the disease has been linked to consumption of raw date palm sap (toddy), eating of fruits partially consumed by bats, and using water from wells inhabited by bats.
File:How the Nipah Virus spreads.png, How the Nipah virus spreads
File:Pteropus vampyrus2.jpg, Fruit bats are the natural reservoirs of Nipah virus
Laboratory diagnosis
During acute and convalescent stages of the disease, RNA can be detected using reverse transcriptase polymerase chain reaction
The polymerase chain reaction (PCR) is a method widely used to rapidly make millions to billions of copies (complete or partial) of a specific DNA sample, allowing scientists to take a very small sample of DNA and amplify it (or a part of it) t ...
(RT-PCR) from throat swab
In medicine, sampling is gathering of matter from the body to aid in the process of a medical diagnosis and/or evaluation of an indication for treatment, further medical tests or other procedures. In this sense, the sample is the gathered matter ...
s, cerebrospinal fluid
Cerebrospinal fluid (CSF) is a clear, colorless body fluid found within the tissue that surrounds the brain and spinal cord of all vertebrates.
CSF is produced by specialised ependymal cells in the choroid plexus of the ventricles of the bra ...
, urine and blood analysis.
After recovery, IgG
Immunoglobulin G (Ig G) is a type of antibody. Representing approximately 75% of serum antibodies in humans, IgG is the most common type of antibody found in blood circulation. IgG molecules are created and released by plasma B cells. Each IgG ...
and IgM
Immunoglobulin M (IgM) is one of several isotypes of antibody (also known as immunoglobulin) that are produced by vertebrates. IgM is the largest antibody, and it is the first antibody to appear in the response to initial exposure to an antig ...
antibody detection can confirm a prior Nipah virus infection. Immunohistochemistry
Immunohistochemistry (IHC) is the most common application of immunostaining. It involves the process of selectively identifying antigens (proteins) in cells of a tissue section by exploiting the principle of antibodies binding specifically to an ...
on tissues collected during autopsy also confirms the disease.
Prevention
Prevention through sanitary practices is the best protection. The likelihood of infection through animal transmission can be reduced by avoiding exposure to sick pigs, and to bats where the disease is endemic. Bats harbor a significantly higher proportion of zoonotic viruses than all other mammalian orders, and are known not to be affected by the many viruses they carry, apparently due to their developing special immune systems to deal with the stress of flying. Infection via bats can be caused by drinking raw palm sap (palm toddy
Palm wine, known by several #Names, local names, is an alcoholic beverage created from the sap of various species of palm tree such as the Borassus, palmyra, date palms, and coconut palms. It is known by various names in different regions and i ...
) contaminated by bat excreta, eating fruits partially consumed by bats, and using water from wells infested by bats. Bats are known to drink toddy that is collected in open containers, and occasionally urinate in it, which contaminates it with the virus; switching to closed-top containers prevents transmission via this route. Outbreaks can be reduced by surveillance and awareness. The association of this disease with the reproductive cycle of bats is not well studied.
Standard infection control practices can protect against human-to-human nosocomial infection
A hospital-acquired infection, also known as a nosocomial infection (from the Greek , meaning "hospital"), is an infection that is acquired in a hospital or other health care facility. To emphasize both hospital and nonhospital settings, it is ...
s.
A subunit vaccine using the Hendra G protein was found to produce cross-protective antibodies against both henipavirus and nipahvirus; this has been used in monkeys to protect against Hendra virus
Hendra virus (HeV), scientific name ''Hendra henipavirus'', is a bat-borne virus that is associated with a highly fatal infection in horses and humans. Numerous disease outbreaks in Australia among horses have been caused by Hendra virus. The Hend ...
, although its potential for use in humans has not been studied.
Treatment
there is no specific treatment for Nipah virus infection. The mainstay of treatment is supportive care
Symptomatic treatment, supportive care, supportive therapy, or palliative treatment is any medical therapy of a disease that only affects its symptoms, not the underlying cause. It is usually aimed at reducing the signs and symptoms for the comfor ...
.[ Standard infection control practices and proper barrier nursing techniques are recommended to avoid the spread of the infection from person to person.][ All suspected cases of Nipah virus infection should be isolated. While tentative evidence supports the use of ]ribavirin
Ribavirin, also known as tribavirin, is an antiviral medication used to treat RSV infection, hepatitis C and some viral hemorrhagic fevers. For hepatitis C, it is used in combination with other medications such as simeprevir, sofosbuvir, pegin ...
, it has not yet been studied in people with the disease.[ Specific antibodies have also been studied in an animal model with potential benefit.][ ]Acyclovir
Aciclovir (ACV), also known as acyclovir, is an antiviral medication. It is primarily used for the treatment of herpes simplex virus infections, chickenpox, and shingles. Other uses include prevention of cytomegalovirus infections following tran ...
, favipiravir
Favipiravir, sold under the brand name Avigan among others, is an antiviral medication used to treat influenza in Japan. It is also being studied to treat a number of other viral infections, including SARS-CoV-2. Like the experimental antiviral ...
,[ and ]remdesivir
Remdesivir, sold under the brand name Veklury, Text was copied from this source which is © European Medicines Agency. Reproduction is authorized provided the source is acknowledged. is a broad-spectrum antiviral medication developed by the ...
have been assessed as potential antivirals against Nipah virus.
M 102.4 is a nonpatented monoclonal antibody developed by Christopher C. Broder, a professor of immunology and microbiology at Uniformed Services University of the Health Sciences in Maryland. It proved highly effective in animal models. 50 doses were sent to Kerala in 2018, but it is not clear if they were used in humans.
AChAdOx1 is vector based vaccination which is currently being tested on animals.
Prognosis
Nipah virus infection is fatal in 40 to 70 percent of cases, though some outbreaks have had 100% case fatality rate.
Sequelae
Those who survive the initial infection often struggle with debilitating long-term neurological sequelae
A sequela (, ; usually used in the plural, sequelae ) is a pathological condition resulting from a disease, injury, therapy, or other trauma. Derived from the Latin word, meaning “sequel”, it is used in the medical field to mean a complication ...
, including memory loss
Amnesia is a deficit in memory caused by brain damage or disease,Gazzaniga, M., Ivry, R., & Mangun, G. (2009) Cognitive Neuroscience: The biology of the mind. New York: W.W. Norton & Company. but it can also be caused temporarily by the use o ...
, impaired cognition, seizures
An epileptic seizure, informally known as a seizure, is a period of symptoms due to abnormally excessive or neural oscillation, synchronous neuronal activity in the brain. Outward effects vary from uncontrolled shaking movements involving much o ...
, convulsions
A convulsion is a medical condition where the body muscles contract and relax rapidly and repeatedly, resulting in uncontrolled shaking. Because epileptic seizures typically include convulsions, the term ''convulsion'' is sometimes used as a s ...
, and personality changes.
Moreover, Nipah virus is known to be able to persist and lie dormant in survivors and to re-activate many months or years after the initial infection. Deaths from re-activation of latent Nipah virus have been reported.
Outbreaks
Nipah virus outbreaks have been reported in Malaysia, Singapore, Bangladesh and India. The highest mortality due to Nipah virus infection was found in Bangladesh, where outbreaks are typically seen in winter. Nipah virus was first seen in 1998 in peninsular Malaysia in pigs and pig farmers. By mid-1999, more than 265 human cases of encephalitis, including 105 deaths, had been reported in Malaysia, and 11 cases of either encephalitis or respiratory illness with one fatality were reported in Singapore. In 2001, Nipah virus was reported from Meherpur District
Meherpur ( bn, মেহেরপুর, pron: ''meɦeɾpuɾ'') is the northwestern district of Khulna Division in southwestern Bangladesh. It is bordered by the Indian state of West Bengal to the west, and by the Bangladeshi districts of Kushtia ...
, Bangladesh and Siliguri
Siliguri, ) is a major tier-II city in West Bengal. It forms twin cities, "Twin Cities" with the neighboring district capital of Jalpaiguri. The city spans areas of the Darjeeling district, Darjeeling and Jalpaiguri districts in the Indian sta ...
, India. The outbreak again appeared in 2003, 2004 and 2005 in Naogaon District
Naogaon District ( bn, নওগাঁ, Nôugã) is a district in northern Bangladesh, part of the Rajshahi Division. It is named after its headquarters, the city of Naogaon in Naogaon Sadar Upazila.
Demographics
According to the 2022 Census ...
, Manikganj District
Manikganj ( bn, মানিকগঞ্জ ) is a district in central Bangladesh. It is a part of the Dhaka Division, In 1845 AD it was at first declared as a sub-division. It was at first, under Faridpur district (Faridpur Zila) then it was in ...
, Rajbari District
Rajbari ( bn, রাজবাড়ী) is a district in central Bangladesh, located in the Dhaka Division. It is a part of the Greater Faridpur subregion of Bengal due to the historical, linguistic and cultural identities of its inhabitants.
His ...
, Faridpur District
Faridpur District ( bn, ফরিদপুর জেলা) is a district in south-central Bangladesh. It is a part of the Dhaka Division. It is bounded by the Padma River to its northeast. The district was named after Farīd-ud-Dīn Masʿūd, ...
and Tangail District
Tangail ( bn, টাঙ্গাইল জেলা) formerly a small Mohokuma of Greater Mymensingh district is a district (''zila'') in the central region of Bangladesh. In 1969, Tangail district was created by Tangail Mohokuma from its 237 ...
. In Bangladesh there were further outbreaks in subsequent years.[
* September 1998 – May 1999: in the states of ]Perak
Perak () is a state of Malaysia on the west coast of the Malay Peninsula. Perak has land borders with the Malaysian states of Kedah to the north, Penang to the northwest, Kelantan and Pahang to the east, and Selangor to the south. Thailand's ...
, Negeri Sembilan
Negeri Sembilan (, Negeri Sembilan Malay: ''Nogoghi Sombilan'', ''Nismilan'') is a state in Malaysia which lies on the western coast of Peninsular Malaysia. It borders Selangor on the north, Pahang in the east, and Malacca and Johor to the s ...
and Selangor
Selangor (; ), also known by its Arabic language, Arabic honorific Darul Ehsan, or "Abode of Sincerity", is one of the 13 Malaysian states. It is on the west coast of Peninsular Malaysia and is bordered by Perak to the north, Pahang to the east ...
in Malaysia
Malaysia ( ; ) is a country in Southeast Asia. The federation, federal constitutional monarchy consists of States and federal territories of Malaysia, thirteen states and three federal territories, separated by the South China Sea into two r ...
. A total of 265 cases of acute encephalitis
Encephalitis is inflammation of the brain. The severity can be variable with symptoms including reduction or alteration in consciousness, headache, fever, confusion, a stiff neck, and vomiting. Complications may include seizures, hallucinations, ...
with 105 deaths caused by the virus were reported in the three states throughout the outbreak. The Malaysian health authorities at first thought Japanese encephalitis
Japanese encephalitis (JE) is an infection of the brain caused by the Japanese encephalitis virus (JEV). While most infections result in little or no symptoms, occasional inflammation of the brain occurs. In these cases, symptoms may include he ...
(JE) was the cause of infection which hampered the deployment of effective measures to prevent the spread of Nipah virus.
* 2001: 31 January – 23 February, Siliguri
Siliguri, ) is a major tier-II city in West Bengal. It forms twin cities, "Twin Cities" with the neighboring district capital of Jalpaiguri. The city spans areas of the Darjeeling district, Darjeeling and Jalpaiguri districts in the Indian sta ...
, India: 66 cases with a 74% mortality rate. 75% of patients were either hospital staff or had visited one of the other patients in hospital, indicating person-to-person transmission.
* 2001: April–May, Meherpur District
Meherpur ( bn, মেহেরপুর, pron: ''meɦeɾpuɾ'') is the northwestern district of Khulna Division in southwestern Bangladesh. It is bordered by the Indian state of West Bengal to the west, and by the Bangladeshi districts of Kushtia ...
, Bangladesh: 13 cases with nine fatalities (69% mortality).
* 2003: January, Naogaon District
Naogaon District ( bn, নওগাঁ, Nôugã) is a district in northern Bangladesh, part of the Rajshahi Division. It is named after its headquarters, the city of Naogaon in Naogaon Sadar Upazila.
Demographics
According to the 2022 Census ...
, Bangladesh: 12 cases with eight fatalities (67% mortality).
* 2004: January–February, Manikganj
Manikganj is a district situated in Dhaka Division, Bangladesh. Manikganj is one of the green and pollution free towns in Bangladesh. The recent urbanization and highway built joining Dhaka and Shingair Upazilla has given it an outstanding road ...
and Rajbari districts, Bangladesh: 42 cases with 14 fatalities (33% mortality).
* 2004: 19 February – 16 April, Faridpur District
Faridpur District ( bn, ফরিদপুর জেলা) is a district in south-central Bangladesh. It is a part of the Dhaka Division. It is bounded by the Padma River to its northeast. The district was named after Farīd-ud-Dīn Masʿūd, ...
, Bangladesh: 36 cases with 27 fatalities (75% mortality). 92% of cases involved close contact with at least one other person infected with Nipah virus. Two cases involved a single short exposure to an ill patient, including a rickshaw driver who transported a patient to hospital. In addition, at least six cases involved acute respiratory distress syndrome, which has not been reported previously for Nipah virus illness in humans.
* 2005: January, Tangail District
Tangail ( bn, টাঙ্গাইল জেলা) formerly a small Mohokuma of Greater Mymensingh district is a district (''zila'') in the central region of Bangladesh. In 1969, Tangail district was created by Tangail Mohokuma from its 237 ...
, Bangladesh: 12 cases with 11 fatalities (92% mortality). The virus was probably contracted from drinking date palm juice contaminated by fruit bat droppings or saliva.
* 2007: February–May, Nadia District
Nadia () is a district in the state of West Bengal, India. It borders Bangladesh to the east, North 24 Parganas and Hooghly districts to the south, Purba Bardhaman to the west, and Murshidabad to the north.
Nadia district is highly influentia ...
, India: up to 50 suspected cases with 3–5 fatalities. The outbreak site borders the Bangladesh district of Kushtia
Kushtia ( bn, কুষ্টিয়া) is a city in the Khulna Division of southwestern Bangladesh. Kushtia is the second largest municipality in Bangladesh and the eleventh largest city in the country. The second largest city in Khulna div ...
where eight cases of Nipah virus encephalitis with five fatalities occurred during March and April 2007. This was preceded by an outbreak in Thakurgaon during January and February affecting seven people with three deaths. All three outbreaks showed evidence of person-to-person transmission.
* 2008: February–March, Manikganj and Rajbari districts, Bangladesh: Nine cases with eight fatalities.
* 2010: January, Bhanga subdistrict, Faridpur, Bangladesh: Eight cases with seven fatalities. During March, one physician of the Faridpur Medical College Hospital caring for confirmed Nipah cases died.
* 2011: February: An outbreak of Nipah Virus occurred at Hatibandha, Lalmonirhat, Bangladesh. The deaths of 21 schoolchildren due to Nipah virus infection were recorded on 4 February 2011. IEDCR confirmed the infection was due to this virus. Local schools were closed for one week to prevent the spread of the virus. People were also requested to avoid consumption of uncooked fruits and fruit products. Such foods, contaminated with urine or saliva from infected fruit bats, were the most likely source of this outbreak.
* 2018: May: Deaths of twenty one people in Perambra
Perambra is a major town in Koyilandy taluk of Kozhikode district in North Malabar region of Kerala state, India. It is one of the 140 assembly constituencies in Kerala, and one of the 12 block Panchayats in Kozhikode district. Perambra lies al ...
near Calicut
Kozhikode (), also known in English as Calicut, is a city along the Malabar Coast in the state of Kerala in India. It has a corporation limit population of 609,224 and a metropolitan population of more than 2 million, making it the second la ...
, Kerala
Kerala ( ; ) is a state on the Malabar Coast of India. It was formed on 1 November 1956, following the passage of the States Reorganisation Act, by combining Malayalam-speaking regions of the erstwhile regions of Cochin, Malabar, South ...
, India were confirmed to be due to the virus. Treatment using antivirals such as Ribavirin was initiated.
* 2019: June: A 23-year-old student was admitted into hospital with Nipah virus infection at Kochi
Kochi (), also known as Cochin ( ) ( the official name until 1996) is a major port city on the Malabar Coast of India bordering the Laccadive Sea, which is a part of the Arabian Sea. It is part of the district of Ernakulam in the state of K ...
in Kerala. Health Minister of Kerala K. K. Shailaja
K. K. Shailaja (born 20 November 1956) is an Indian politician and former Health Minister of Kerala who hails from Kannur district.
Shailaja currently serves as the Member of the Legislative Assembly (MLA) representing Mattanur constituency ...
said that 86 people who had had recent interactions with the patient were under observation. This included two nurses who treated the patient, and had fever and sore throat. The situation was monitored and precautionary steps were taken to control the spread of virus by the Central
Central is an adjective usually referring to being in the center of some place or (mathematical) object.
Central may also refer to:
Directions and generalised locations
* Central Africa, a region in the centre of Africa continent, also known as ...
and State Government
A state government is the government that controls a subdivision of a country in a federal form of government, which shares political power with the federal or national government. A state government may have some level of political autonomy, or ...
. The Health Department of Kerala kept 338 people under observation, 17 of them in isolation. After undergoing treatment for 54 days at a private hospital, the 23-year-old student was discharged. On 23 July, the Kerala government declared Ernakulam district to be Nipah-free.
* 2021: September: 12-year-old boy, a native of Chathamangalam
Chathamangalam is a village in Kozhikode district of Kerala state, India.
Geography
Chathamangalam is a gram panchayat is an agricultural village comprising hills, valleys, and paddy fields. It spreads over 40.23 km2 and 20 km east ...
village was admitted to a hospital at Kozhikode
Kozhikode (), also known in English as Calicut, is a city along the Malabar Coast in the state of Kerala in India. It has a corporation limit population of 609,224 and a metropolitan population of more than 2 million, making it the second la ...
in Kerala on September 1. He died from the virus four days after admission. Two healthcare workers who came into contact with the victim were already showing symptoms of Nipah infection by Monday.
Research
Ribavirin
Ribavirin, also known as tribavirin, is an antiviral medication used to treat RSV infection, hepatitis C and some viral hemorrhagic fevers. For hepatitis C, it is used in combination with other medications such as simeprevir, sofosbuvir, pegin ...
, m102.4 monoclonal antibody, and favipiravir
Favipiravir, sold under the brand name Avigan among others, is an antiviral medication used to treat influenza in Japan. It is also being studied to treat a number of other viral infections, including SARS-CoV-2. Like the experimental antiviral ...
were being studied as treatments as of 2019.
Medication
Ribavirin has been studied in a small number of people. it was unclear whether it was useful, although a few people had returned to normal life after treatment. In vitro
''In vitro'' (meaning in glass, or ''in the glass'') studies are performed with microorganisms, cells, or biological molecules outside their normal biological context. Colloquially called "test-tube experiments", these studies in biology an ...
studies and animal studies have shown conflicting results in the efficacy of ribavirin against NiV and Hendra, with some studies showing effective inhibition of viral replication in cell lines, whereas some studies in animal models showed that ribavirin treatment only delayed but did not prevent death after NiV or Hendra virus infection.
In 2013 the anti-malarial drug chloroquine
Chloroquine is a medication primarily used to prevent and treat malaria in areas where malaria remains sensitive to its effects. Certain types of malaria, resistant strains, and complicated cases typically require different or additional medi ...
was shown to block the critical functions needed for maturation of Nipah virus, although no clinical benefit was observed.
Immunization
Passive immunization Passive immunity is the transfer of active humoral immunity of ready-made antibodies. Passive immunity can occur naturally, when maternal antibodies are transferred to the fetus through the placenta, and it can also be induced artificially, when hi ...
using a human monoclonal antibody, m102.4, that targets the ephrin-B2 and ephrin-B3 receptor-binding domain of the henipavirus Nipah G glycoprotein was evaluated in the ferret model as post-exposure prophylaxis. m102.4 has been used in people on a compassionate use
Expanded access or compassionate use is the use of an unapproved drug or medical device under special forms of investigational new drug applications (IND) or IDE application for devices, outside of a clinical trial, by people with serious or life ...
basis in Australia, and was in pre-clinical development in 2013.
Popular culture
The fictional MEV-1 virus featured in the 2011 film '' Contagion'' was based on a combination of Nipah and measles virus
''Measles morbillivirus'' (MeV), also called measles virus (MV), is a single-stranded, negative-sense, enveloped, non-segmented RNA virus of the genus ''Morbillivirus'' within the family ''Paramyxoviridae''. It is the cause of measles. Human ...
.
A Malayalam movie, ''Virus
A virus is a submicroscopic infectious agent that replicates only inside the living cells of an organism. Viruses infect all life forms, from animals and plants to microorganisms, including bacteria and archaea.
Since Dmitri Ivanovsky's 1 ...
'', was released in 2019, based on the 2018 outbreak of Nipah virus in Kerala
Kerala ( ; ) is a state on the Malabar Coast of India. It was formed on 1 November 1956, following the passage of the States Reorganisation Act, by combining Malayalam-speaking regions of the erstwhile regions of Cochin, Malabar, South ...
, India
India, officially the Republic of India (Hindi: ), is a country in South Asia. It is the seventh-largest country by area, the second-most populous country, and the most populous democracy in the world. Bounded by the Indian Ocean on the so ...
.
In Series 4 Episode 1 of The Good Karma Hospital
''The Good Karma Hospital'' is a medical drama series produced by Tiger Aspect Productions for ITV about a disillusioned doctor, Ruby Walker, who travels to South India hoping to make a fresh start. It stars Amanda Redman, Amrita Acharia, Ja ...
a patient is admitted with Nipah.
See also
* Coalition for Epidemic Preparedness Innovations
The Coalition for Epidemic Preparedness Innovations (CEPI) is a foundation that takes donations from public, private, philanthropic, and civil society organisations, to finance independent research projects to develop vaccines against emerging ...
References
{{Authority control
Chiroptera-borne diseases
Swine diseases
Viral diseases
Wikipedia medicine articles ready to translate
Zoonoses